In Your righteousness deliver me and rescue me... Psalm 71:2
Join Us for a summer filled with:
Fun & Educational Exploratory Classes
Weekly Field Trips
Specialized Program for Primary Students
Fun Filled Theme Days
Guest Speakers
Arts & Crafts, Games, & Sports
Water Play & Swim Days
Optional Week Long Enrichment Camps
Save $10 on registration if registration
is Completed by Friday, May 18th
In a Hurry? Register quickly on the
***Week #1 June 18th — 22nd*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Fun On Campus Movies@Triangle Knott’s Soak Summer Kick Activities (Incredibles 2) City Off Party
***Week #2 June 25th — 29th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Games In/Games Out Bowling @ Irvine Lanes California Reptile Show Weird Science Science Center Adventures in Art Jr. Mates: Dino-Mite!
***Week #3 July 2nd — 6th No Camp July 4th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Games In/Games Out Roller Skating Little Corona Castaway Day Weird Science FV Skate Center Beach& Tide Pools Mini Golf/Treasure Hunt Adventures in Art Jr. Mates: Circuits for Kids
***Week #4 July 9th — 13th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Vacation Bible School Sky Zone Johns Incredible Minute 2 Win It All Week Long Pizza Cost included in Camp
***Week #5 July 16th — 20th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Creators Challenge Kayaking @ NAC Knott’s Berry Nerf Wars Comic Book Makers Farm Foods of the World Jr. Mates: Magnets In Motion
***Week #6 July 23rd — 27th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Creators Challenge Balboa Fun Zone San Diego Zoo Mad Science Day Comic Book Makers Science Presentation Foods of the World Jr. Mates: Super Science Sleuths
***Week #7 July 30th — August 3rd*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Robotics for Beginners Rock Climbing Disneyland Travel to the Stars Bake Me A Cake Rockreation Inflatable Planetarium Twisted Sports Jr. Mates: Out of this World
***Week #8 August 6th — 10th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Robotics for Beginners Roller Skating OC Fair Super Hero Day Bake Me A Cake FV Skate Center Twisted Sports Jr. Mates: Lego Engineering
***Week #9 August 13th — 17th*** Mon: Inventors Challenge Terrific Tuesday: Field Trip: Fun Friday: Tues: Who Done It? Kids Choice Raging Waters End of Camp Wed: Game Show Mania BBQ & Party Junior Mates: Crazy Creators
Christ Lutheran School Age Care - Summer Camp 2017 Registration Form
Child’s Name:_____________________________________ Grade Fall 2017:_______
Address:____________________________________________________________
Family E-Mail:________________________________________________________
Parent’s Name:____________________________ Main Phone#:_________________
Please Circle Shirt Size: Youth S M L Adult S M L
Please Mark All Days Needed, Circling Half Day or Full Day - Days May Be Changed After Registration
Payments will be charged to FACTS Tuition Accounts Please Sign Authorization on Policy Agreement
All Students Attend Thursday Field Trips
Terrific Tuesday Field Trips are optional for 3rd Grade & Up (Additional Cost)
Wet Wednesdays are not available to Incoming Kindergarten Students
All Fees are collected through FACTS Tuition, to set up an account, please visit
https://online.factsmgt.com/SignIn/3D16Q
Full Time 7am-6pm
Includes Field Trip
$220
Daily Rate 7am-6pm
not valid on Thursday
$55
Field Trip Rate
(Thursdays)
$80
Half Day Rate
7am-12/12-5pm
$30
Drop In Care
Daily Rate
$75
Exploratory Clubs Mon-Wed 8am-12:00
$80
June 18 - 22 Example
19 X Half Day Full Day
18
On Campus Activities
Half Day Full Day
19 Terrific Tuesday Movies@Triangle
Incredibles 2 Half Day Full Day
22
Wet Wednesday: Beach Day
Half Day Full Day
21
Field Trip: Knott’s Soak City
No 1/2 days
22
Summer Kick Off
Party Half Day Full Day
Payment Method
Facts 6/11
Amount Due:
$__________
June 25 - 29 Exploratory Clubs Session #1 Games In/Games Out Weird Science Adventures In Art Junior Mates: Dino-Mite!
25
On Campus Activities
Half Day Full Day
26 Terrific Tuesday
Bowling @ Irvine Lanes
Half Day Full Day
27
Wet Wednesday: Pool Day
Half Day Full Day
28
Field Trip California Science
Center No 1/2 days
29
Reptile Day Reptile Show
Half Day Full Day
Payment Method
Facts 6/18
Amount Due:
$__________
July 2 - 6 Exploratory Clubs Session #1 Games In/Games Out Weird Science Adventures In Art Junior Mates: Circuits for Kids
2
On Campus Activities
Half Day Full Day
3 Terrific Tuesday
Roller Skating@ FV Skate
Half Day Full Day
4
No Camp Today
5
Field Trip Little Corona Beach
& Tide Pools
No 1/2 days
6 Castaway Day
Mini Golf/Treasure Hunt
Half Day Full Day
Payment Method
Facts 6/25
Amount Due:
$__________
July 9 - 13
VBS The cost of VBS is included in your weekly tuition.
9 VBS
On Campus Activities
Half Day Full Day
10 VBS Terrific Tuesday
Sky Zone Jump Half Day Full Day
11 VBS Wet Wednesday
Pool Day
Half Day Full Day
12 VBS
Field Trip John’s Incredible
Pizza No 1/2 days
13 VBS
Minute 2 Win It Games Day
Half Day Full Day
Payment Method
Facts 7/02
Amount Due:
$__________
July 16 - 20 Exploratory Clubs Session #2 Creators Challenge Comic Book Makers Foods of the World Junior Mates: Magnets in Motion
16
On Campus Activities
Half Day Full Day
17 Terrific Tuesday
Kayaking @ Newport Aquatic
Half Day Full Day
18 Wet Wednesday
Beach Day Half Day Full Day
19
Field Trip Knotts Berry Farm
No 1/2 days
20
Nerf Battle
Half Day Full Day
Payment Method
Facts 7/09
Amount Due:
$__________
July 23- 27 Exploratory Clubs Session #2 Creators Challenge Comic Book Makers Foods of the World Junior Mates: Super Science Slueths
23
On Campus Activities
Half Day Full Day
24 Terrific Tuesday
Balboa Fun Zone Half Day Full Day
25 Wet Wednesday
Pool Day
Half Day Full Day
26
Field Trip San Diego Zoo
No 1/2 days
27
Mad Science Science Show
Half Day Full Day
Payment Method
Facts 7/16
Amount Due:
$__________
July 30 - August 3 Exploratory Clubs Session #3 Robotics for Beginners Bake Me A Cake Twisted Sports Junior Mates: Out of this World
30
On Campus Activities
Half Day Full Day
31 Terrific Tuesday
Newport Dunes Water Park
Half Day Full Day
1 Wet Wednesday
Beach Day
Half Day Full Day
2
Field Trip Disneyland
No 1/2 days
3 Travel to the Stars
Inflatable Planetarium
Half Day Full Day
Payment Method
Facts 7/23
Amount Due:
$__________
August 6 - 10 Exploratory Clubs Session #3 Robotics for Beginners Bake Me A Cake Twisted Sports Funbots Club: Lego Engineering
6
On Campus Activities
Half Day Full Day
7 Terrific Tuesday
Rock Climbing Rockreation
Half Day Full Day
8 Wet Wednesday
Pool Day
Half Day Full Day
9
Field Trip Orange Couty
Fair No 1/2 days
10
Super Hero Day
Half Day Full Day
Payment Method
Facts 7/30
Amount Due:
$__________
August 13 - 17 Monday: Inventors Challenge Tuesday: Who Done It? Wednesday: Game Show Mania Junior Mates: Crazy Creators
13
On Campus Activities
Half Day Full Day
14 Terrific Tuesday
Kids Choice Half Day Full Day
15 Wet Wednesday
Beach Day Half Day Full Day
16
Field Trip Raging Waters
No 1/2 days
17 Last Day of Summer
Whacky Water Day BBQ & Party
Half Day Full Day
Payment Method
Facts 8/06
Amount Due:
$__________
Full Time (7:00am - 6:00pm) $220.00 per week (Includes Thurs Field Trip)
Daily Rate (7:00am - 6:00pm) $60 per day
Drop In Rate (7:00am - 6:00pm) $80 per day
Thursday Field Trip Only Daily Rate $80 per day
1/2 Day Rate not available on Thursday Field Trips
Exploratory Classes Only $80 per week
(Mon-Wed 8am-12noon)
1/2 Day Rate (7:00am-12:00/12:00-5pm) $35 per day
1/2 Day Rate not available on Thursday Field Trips
Registration Fees
CLS Families Early Registration until 5/18 $50 per camper
Non CLS Families Early Registration until 5/18 $75 per camper
CLS Families Registration after 5/18 $60 per camper
Non CLS Families Early Registration after 5/18 $85 per camper
10% sibling discount available on tuition
1/2 day rates apply to campers who are also enrolled in week-long enrichment camps. No 1/2 day care available on Thursdays.
All Fees are collected through FACTS Tuition, to set up an account, please visit
https://online.factsmgt.com/SignIn/3D16Q
Tuition:
I agree to pay all tuition and fees required in accordance with the Tuition Policy. Tui-
tion is charged through our FACTS Tuition system. Tuition will be charged to your
account on the Monday before your child’s attendance. A late fee of $20 will apply to
all late payments. Please sign the authorization below to allow this withdrawal:
I hereby give Christ Lutheran permission to charge my weekly Summer
Camp fees to my FACTS Tuition account:
_____________________________________________________
Signature Date
Late Pick Up Fees:
There is a late pick-up fee of $1.00 per minute, per child past 6:00pm, unlimited.
This fee will be added to your FACTS Tuition Account.
Policies:
Discipline: Should there be a behavior/discipline problem w ith your
child during the Summer Camp program, you may be called to pick-up your child im-
mediately at the discretion of the SAC Director. If a child continues to have a behav-
ior/discipline problem, he/she may be removed from the Summer Camp program at
the discretion of the SAC Director.
Handbook: I have read the SAC Sum m er Handbook and agree to adhere
to all the policies and procedures stated within.
Signature _______________________________ Date _______________
Student Name _______________________________________________
Legal Name of Student ______________________________________ Male Female
Last First M.I.
Address _______________________________ City ________________ Zip _________
Home Telephone ( ) ______________ Date of Birth ____________ Grade in Fall _______
Father’s Name _____________________ Mother’s Name __________________________
Address _________________________ Address _______________________________
(if different from student) (if different from student)
Home Phone ( ) __________________ Home Phone ( ) _________________________
(if different from student) (if different from student)
Cell Phone ( ) ____________________ Cell Phone ( ) _______________________
Work Phone ( ) ___________________ Work Phone ( ) ______________________
This child is living with… Both Parents Father Only Mother Only Father & Stepmother
Mother & Stepfather Other (explain)___________________
If divorced, who has legal custody of student? Father Mother Joint Custody
Is there any physical condition, which needs special consideration in the event of emergency, such as
allergies to medicine or food, a cardiac condition, diabetes, etc.? _________________________
_____________________________________________________________________
In the event that my child should have a sudden illness or an accident and the home cannot be reached, I here-by request that one of the following physicians be called to render first aid and or emergency treatment. It is also understood that if it is judged that immediate emergency care is necessary that I authorize the school or its designee to contact the emergency medical service for immediate treatment. It is understood that I will pay any and all fees incurred by such treatment, which are not immediately available, the school may select one for such treatment, and I will be responsible for the fees incurred. This agreement will be in effect as long as this student is enrolled unless revoked by the parent in writing.
Child’s Doctor: _______________________ City ___________________ Phone: ______________
Child’s Dentist: _______________________ City ___________________ Phone ______________
Preferred Hospital: _______________________________ City ___________________________
Medical Insurance Carrier: __________________________ Policy Number: ___________________
Person’s authorized to contact for emergency and/or pick up child from school other than mother and father listed above
Signature of Parent or Legal Guardian: _____________________________Date:_______________
Name Relationship Home Phone Work Phone Cell Phone
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